Information Collection Requirements In Bpo-41p, Adjustment Of Federal Share For Uncashed Or Cancelled Checks, 45 Cfr Sections 201.5 (a)(3), 201.67 (c)(2) & 201.67(d)(2)

INFORMATION COLLECTION REQUIREMENTS IN BPO-41P, ADJUSTMENT OF FEDERAL SHARE FOR UNCASHED OR CANCELLED CHECKS, 45 CFR SECTIONS 201.5 (A)(3), 201.67 (C)(2) & 201.67(D)(2)

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Information Collection (IC) Details

IC Title:	INFORMATION COLLECTION REQUIREMENTS IN BPO-41P, ADJUSTMENT OF FEDERAL SHARE FOR UNCASHED OR CANCELLED CHECKS, 45 CFR SECTIONS 201.5 (A)(3), 201.67 (C)(2) & 201.67(D)(2)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-R-67				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	1	1
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.